| Rose Hulman | |
|
5500 Wabash Ave Terre Haute IN 47803-3920 | |
| (812) 877-8367 | |
| (812) 872-6225 |
| Full Name | Rose Hulman |
|---|---|
| Speciality | Family Medicine |
| Location | 5500 Wabash Ave, Terre Haute, Indiana |
| Authorized Official Name and Position | Michael P Fouty (CFO) |
| Authorized Official Contact | 8122423434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rose Hulman 221 S 6th St Terre Haute IN 47807-4214 Ph: (812) 232-0564 | Rose Hulman 5500 Wabash Ave Terre Haute IN 47803-3920 Ph: (812) 877-8367 |
| NPI Number | 1184028912 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 10/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184028912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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